A nurse is teaching a newly licensed nurse about didanosine therapy.
Which of the following client conditions should the nurse identify as an indication for treatment with didanosine?
Tuberculosis.
Human immunodeficiency virus.
Bacterial meningitis.
Syphilis.
The Correct Answer is B
Choice A rationale
Tuberculosis is a bacterial infection primarily affecting the lungs, caused by *Mycobacterium tuberculosis*. Didanosine is an antiretroviral medication, specifically a nucleoside reverse transcriptase inhibitor (NRTI), and as such, it does not possess antimicrobial activity against bacterial pathogens like *Mycobacterium tuberculosis*. Therefore, it is not indicated for treating tuberculosis.
Choice B rationale
Human immunodeficiency virus (HIV) is a retrovirus that attacks the body's immune system. Didanosine is an antiretroviral drug that inhibits the replication of HIV by interfering with the reverse transcriptase enzyme, which is crucial for the virus to convert its RNA into DNA. This mechanism of action effectively reduces the viral load and improves immune function in individuals with HIV infection.
Choice C rationale
Bacterial meningitis is an inflammation of the meninges, the membranes surrounding the brain and spinal cord, caused by various bacterial species. Didanosine is an antiviral agent specifically targeting retroviruses like HIV. It does not have any direct antibacterial properties or efficacy against the common bacterial pathogens responsible for meningitis, thus making it an inappropriate treatment.
Choice D rationale
Syphilis is a sexually transmitted infection caused by the bacterium *Treponema pallidum*. The primary treatment for syphilis is antibiotics, particularly penicillin. Didanosine, being an antiretroviral medication, does not exhibit any treponemicidal activity and is ineffective against *Treponema pallidum*. Therefore, it is not used in the treatment of syphilis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Mannitol is an osmotic diuretic that increases the osmolality of the glomerular filtrate, thereby inhibiting water reabsorption in the renal tubules. This osmotic effect leads to increased water excretion and subsequently an improved urinary output. This enhanced diuresis is a primary therapeutic goal, particularly in conditions like cerebral edema or acute renal failure.
Choice B rationale
Mannitol is not indicated for the resolution of diabetic ketoacidosis. Diabetic ketoacidosis is a metabolic emergency characterized by hyperglycemia, ketonemia, and acidosis, requiring insulin therapy, fluid resuscitation, and electrolyte management. Mannitol does not address the underlying pathophysiology of insulin deficiency.
Choice C rationale
Mannitol's mechanism of action does not directly decrease brain natriuretic peptide (BNP) levels. BNP is a hormone released by cardiomyocytes in response to ventricular stretch and is a marker of heart failure. While mannitol can reduce fluid overload, which might indirectly impact cardiac preload, its direct effect is not on BNP secretion.
Choice D rationale
Mannitol is used to decrease, not increase, intraocular pressure. Its osmotic properties draw fluid from the extravascular space, including the vitreous humor of the eye, into the vascular compartment. This reduction in fluid volume within the eye lowers intraocular pressure, making it useful in treating acute angle-closure glaucoma.
Correct Answer is C
Explanation
Choice A rationale
Urinary retention is a potential adverse effect of opioid analgesics like meperidine due to their anticholinergic effects, which can relax the detrusor muscle and increase bladder sphincter tone. While important to monitor, it is not the most immediate life-threatening concern compared to respiratory depression.
Choice B rationale
Vomiting is a common gastrointestinal adverse effect of opioid analgesics, often due to stimulation of the chemoreceptor trigger zone in the brainstem. While distressing for the client and requiring intervention, it does not pose the immediate life-threatening risk that respiratory depression does.
Choice C rationale
Meperidine is an opioid agonist that acts on mu-opioid receptors in the central nervous system, including the brainstem respiratory centers. This can lead to dose-dependent respiratory depression by decreasing the sensitivity of these centers to carbon dioxide, making a depressed respiratory rate (normal range 12-20 breaths/min) the priority assessment for client safety.
Choice D rationale
Altered level of consciousness, such as drowsiness or sedation, is a common central nervous system effect of meperidine. While a significant finding indicating opioid effect, it is secondary in priority to respiratory depression, which directly impacts vital gas exchange and can quickly become life-threatening.
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